Lydia Ndi Ejacha

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R229134 Issued in MD

Practice address

9135 Piscataway Rd Ste 410
Clinton, MD 20735-2555

Phone

(240) 688-5033

NPI assigned

May 28, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1245590983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 FAIRVIEW AVE",
            "address_2": "302",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209125978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 PISCATAWAY RD STE 410",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352555",
            "telephone_number": "240-688-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJACHA",
        "first_name": "LYDIA",
        "middle_name": "NDI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-28",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R229134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiena Nichole Edwards
• Deke N Effiong
• Nkechi Egbogu
• Derek Ego-Osuala, D.D.S., MS
• Alisa Ehrmann, DPT
• Ignatius Ekekwe
• Sophie Elangue
• Nichodemus Elebeke, PHARM D
• Marlon Ellerbee Jr.
• Ellis House of Fitness & Rehabilitation Center

• Psychiatric/Mental Health Nurse Practitioner in Clinton, MD
• Providers in Clinton, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.